As an ICD-10 trainer, five years ago I was knee-deep in instructor-led training. The landscape was exciting and new, and it was exhilarating to be
The Centers for Medicare & Medicaid Services (CMS) released the 2018 ICD-10-CM files last week, exciting many in the healthcare industry. The 2018 files contain
My question is a follow-up to last week’s question and answer about Medicare’s definition of a new patient. Would a patient still be considered “new” if only a diagnostic test was performed?
What code is reported for aspiration/drainage procedures?
What is the outpatient PPS packaging threshold for this year?
Does CMS permit a hospital to bill for lab services delivered to an ESRD patient?
Can we bill for a temporary pacemaker (33210) and permanent pacemaker (33208) performed on the same day but at different sessions if modified appropriately?
If lymphoscintigraphy is performed in both breasts, I report 78195 and A9520 x 1 each. Code 78195 has a medically unlikely edit (MUE) of 1. A9520 is per study dose, but bilateral breasts are considered one study, not two. However, if both breasts are injected but imaging is not performed, I report 38792 x 2 and A9520 x 1. I don’t understand why they aren’t reported the same number of times. Can you explain?
Monday, June 19, 201710–10:30 a.m. ET; 7–7:30 a.m. PT FEATURINGJanelle Ali-Dinar, PhD; Nancy Beckley, MS, MBA, CHC; William Dombi, Esq.; David Glaser, Esq.;Ronald Hirsch,
EDITOR’S NOTE: Edward Roche, in association with RACmonitor, is writing a series on the need for healthcare facilities in the U.S. to protect themselves from
The Inpatient Rehabilitation Facility (IRFs) Prospective Payment System (PPS) final rule for the 2018 federal fiscal year was published May 3, 2017, and comments are
A pathway to sustainability for rural healthcare could be the new Accountable Care Organization (ACO) model called the Medicare ACO Track 1+. Announced by the
Traditional utilization management models can no longer keep pace with regulatory shifts, payer scrutiny, and operational pressures. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, ACPA-C, introduces an Adaptive Model strategy that modernizes UM through role specialization, technology-driven workflows, and proactive, team-based processes. Attendees will learn how to restructure programs to improve efficiency, strengthen clinical collaboration, and enhance financial performance in a rapidly changing healthcare environment.
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Breast biopsy procedures may be clinically straightforward but accurately translating them into compliant billing can be anything but. In this focused webcast, Shawn Blackburn, CPC, CPMA, CIC, CRC, CCS-P breaks down how imaging guidance, lesion count, laterality, and payer expectations all impact how these procedures should be reported. Through clear explanations and real-world scenarios, you’ll gain practical insight into aligning clinical workflows with billing requirements, avoiding common pitfalls, and ensuring your documentation supports accurate reimbursement and compliance.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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